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@ARTICLE{Rosen:910208,
      author       = {Rosen, Jurij and Ceccon, Garry and Bauer, Elena Katharina
                      and Werner, Jan Michael and Tscherpel, Caroline and Dunkl,
                      Veronika and Rapp, Marion and Sabel, Michael and Herrlinger,
                      Ulrich and Heinzel, Alexander and Schaefer, Niklas and Ruge,
                      Maximilian and Goldbrunner, Roland and Stoffels, Gabriele
                      and Kabbasch, Christoph and Fink, Gereon Rudolf and Langen,
                      Karl-Josef and Galldiks, Norbert},
      title        = {{C}ost-effectiveness of 18 {F}-{FET} {PET} for early
                      treatment response assessment in glioma patients following
                      adjuvant temozolomide chemotherapy},
      journal      = {Journal of nuclear medicine},
      volume       = {63},
      number       = {10},
      issn         = {0022-3123},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {FZJ-2022-03685},
      pages        = {1677-1682},
      year         = {2022},
      abstract     = {Rationale: In light of increasing healthcare costs, higher
                      medical expenses should be justified socio-economically.
                      Therefore, we calculated the effectiveness and
                      cost-effectiveness of positron emission tomography (PET)
                      using the radiolabeled amino acid
                      O-(2-[18F]-fluoroethyl)-L-tyrosine (18F-FET) compared to
                      conventional magnetic resonance imaging (MRI) for early
                      identification of responders to adjuvant temozolomide
                      chemotherapy. A recently published study in isocitrate
                      dehydrogenase-wildtype glioma patients suggested that
                      18F-FET PET parameter changes predicted a significantly
                      longer survival already after two cycles while MRI changes
                      were not significant. Methods: To determine the
                      effectiveness and cost-effectiveness of serial 18F-FET PET
                      imaging, we analyzed published clinical data and calculated
                      the associated costs from the perspective of the German
                      Statutory Health Insurance system. Based on a decision-tree
                      model, the effectiveness of 18F-FET PET and MRI was
                      calculated, i.e., the probability to correctly identify a
                      responder as defined by an overall survival ≥15 months. To
                      determine the cost-effectiveness, the incremental
                      cost-effectiveness ratio (ICER) was calculated, i.e., the
                      cost for each additionally identified responder by 18F-FET
                      PET who would have remained undetected by MRI. The
                      robustness of the results was tested by deterministic and
                      probabilistic Monte Carlo sensitivity analyses. Results:
                      Compared to MRI, 18F-FET PET increased the rate of correctly
                      identified responders to chemotherapy by $26\%;$ thus, four
                      patients needed to be examined by 18F-FET PET to identify
                      one additional responder. Considering the respective cost
                      for serial 18F-FET PET and MRI, the ICER resulted in
                      €4,396.83 for each additional correctly identified
                      responder by 18F-FET PET. Sensitivity analyses confirmed the
                      robustness of the results. Conclusion: In contrast to
                      conventional MRI, the model suggests that 18F-FET PET is
                      cost-effective in terms of ICER values. Considering the high
                      cost of temozolomide, the integration of 18F-FET PET has the
                      potential to avoid premature chemotherapy discontinuation at
                      reasonable cost.},
      cin          = {INM-4 / INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-3-20090406},
      pnm          = {5253 - Neuroimaging (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5253},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {35422443},
      UT           = {WOS:000968142600011},
      doi          = {10.2967/jnumed.122.263790},
      url          = {https://juser.fz-juelich.de/record/910208},
}